Alapfogalmak
Lowering blood pressure to 120 mm Hg reduces cardiovascular events significantly.
Kivonat
The ESPRIT trial focused on intensive blood pressure lowering to a systolic target below 120 mm Hg compared to standard treatment targeting below 140 mm Hg. Lead investigator Jing Li reported a 12% lower incidence of major vascular events, 39% lower cardiovascular mortality, and 21% lower all-cause mortality with intensive treatment. The trial included high-risk individuals, including those with diabetes and a history of stroke, showing benefits extended to these groups. Results indicated the prevention of 14 major vascular events and eight deaths per 1000 individuals treated for 3 years. The trial highlighted the potential to save lives and reduce heart disease burden globally. The study was presented at the AHA Scientific Sessions 2023, involving 11,255 Chinese adults with baseline systolic blood pressure measurements. The primary outcome showed a 12% reduction in events with intensive treatment, with positive trends in individual endpoints. Serious adverse events included an increase in syncope in the intensive group.
Statisztikák
"Intensive blood pressure lowering treatment targeting a systolic pressure below 120 mm Hg for 3 years resulted in a 12% lower incidence of major vascular events, a 39% lower cardiovascular mortality, and 21% lower all-cause mortality than the standard treatment targeting a systolic pressure below 140 mm Hg," reported lead investigator, Jing Li, MD.
"After 3.4 years of follow-up, 624 primary outcome events had occurred in the standard arm (3.6%) vs 547 events in intensive arm (3.2%), a reduction of 12% (hazard ratio [HR], 0.88; 95% CI, 0.78-0.99)."
"Cardiovascular death occurred in 0.5% of the standard group vs 0.3% of the intensive group (HR 0.61; 95% CI, 0.44-0.84); and all-cause death occurred in 1.1% of the standard group vs 0.9% of the intensive group (HR, 0.79; 95% CI, 0.64-0.97)."
Idézetek
"When we look at meta-analysis of trials of different levels of blood pressure reduction, all the studies show the same thing – the lower the blood pressure, the better the outcome, with those starting at higher levels gaining the greatest benefit of blood pressure reductions," noted Paul Whelton, MD.
"ESPRIT is a nicely done trial. It is reassuring because it is consistent with the other trials, in that it seems that the benefits are much greater than the risk of adverse effects," added Whelton.